Xi Jinping has raised concerns about the spread of Covid-19 to rural China on the eve of the lunar new year, in the Chinese president’s most direct acknowledgment of the worsening health crisis since he suddenly abandoned his zero-Covid strategy to beginning of December.

China’s Lunar New Year holiday marks the world’s largest annual human migration. Officials forecast the country’s 1.4 billion people will make 2 billion trips to see family in the coming weeks, about two-thirds of pre-pandemic levels.

Experts have warned that the period could become the biggest superspreading event since the virus first emerged in Wuhan, central China, in late 2019.

Xi, who was speaking at the Great Hall of the People in Beijing, said he was now “primarily concerned with rural areas and rural residents” as China entered a “new phase” of its response to the pandemic.

China’s most powerful leader since Mao Zedong has demanded greater efforts from lower-level officials to increase medical resources and better prepare for treatment of serious cases. He also ordered “tighter” health measures to be reintroduced in “nursing homes and welfare centers” given the vulnerability of China’s elderly.

For many urban Chinese, the holidays mark their first trip home in three years, but anxiety lingers over the spread of the infection to less protected rural areas. Before Xi’s speech, the authorities were already discouraging travel and large gatherings.

After Beijing lifted its zero-Covid restrictions last month, outbreaks spiked in urban areas and internal government estimates suggest hundreds of millions of people have contracted the virus in a matter of weeks. Authorities reported nearly 60,000 Covid-related deaths in hospitals across the country since the end of the restrictions.

The State Council, China’s cabinet, issued strict guidelines last week urging villagers to limit temple gatherings, festival performances and other mass gatherings in rural areas. The guidelines also urged those returning home to “reduce contact with the elderly, especially those with underlying medical conditions.”

In recent weeks, officials in several rural counties in Hunan, Shaanxi and Heilongjiang provinces have issued warnings, and a local government has advised people “not to return to their hometowns unless necessary.”

Commuters at the Chengdu East railway station in China's Sichuan province this month
China’s transport ministry has forecast that around 2 billion trips will be made during the holidays this year, double the number recorded last year during the height of the covid travel restrictions © Qilai Shen/Bloomberg

The caution partly reflects concerns about poorer health care infrastructure and drug shortages in rural areas. State media reported this month that a central government agency in charge of rural development instructed local authorities that “the availability of medicines in China’s rural areas must be maintained for more than two weeks.”

Zeng Guang, China’s former chief epidemiologist at the Center for Disease Control and Prevention, told officials to focus on pandemic management efforts such as opening designated Covid wards and distributing medicines in the field, according to a local media report last Thursday.

“Our priority focus so far has been on big cities,” Zeng said. “It is time to focus on rural areas. Many of the elderly, sick and disabled in the countryside are falling behind in terms of Covid treatment.”

The influx of travel could provide a much-needed economic boost, as Chinese consumers tend to spend more on food, alcohol and new clothes during the holidays. “We will see many more consumers participate in tourism, which could help boost overall spending,” said Ernan Cui, a China consumer analyst at Gavekal Dragonomics.

But Gavekal’s recent research also suggests that Chinese consumers remain cautious and many are prepared to delay purchases for fear of catching the virus themselves or their family members. Retail sales fell 1.8 percent on-year in December, an improvement from November’s 5.9 percent drop, official data showed Tuesday.

“High-income groups, those least affected by covid and already seeing the benefits of relaxed restrictions, are more likely to engage in ‘revenge drinking,’” Cui said, referring to demand pent up after years of closures. “This is already visible in cities like Beijing. Most people, however, are still a bit careful.”

Travel advisories issued by rural counties have not included concrete legal measures and are unlikely to discourage citizens, many of whom remain determined to travel home.

The government’s decision in December to stop publishing daily case data encouraged Li, a 41-year-old migrant worker in Beijing, to buy train tickets to her hometown in Hubei province. Her hope that covid was over for most of her meant she wasn’t going to “change my travel plans,” she said.

At the Beijing train station, a migrant worker was preparing to return home to Hebei province. “In my town, many people have already been infected,” said the worker. “There are no official rules anymore. What does the government care if I go or not?